DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS:
Left forearm laceration.
POSTOPERATIVE DIAGNOSES:
1. Left forearm laceration.
2. Left radial artery transection.
OPERATION PERFORMED:
1. Left forearm exploration.
2. Left radial artery repair.
SURGEON: John Doe, MD
ANESTHESIA: General inhalation anesthesia.
ESTIMATED BLOOD LOSS: Minimal.
SPECIMEN: None.
OPERATIVE FINDINGS:
1. Radial artery was completely transected.
2. Flexor carpi radialis was partially transected about 20% of its width.
3. About two or three deep flexor tendon muscle bellies were also lacerated and that is where most of the bleeding and oozing and hematoma were from. There was a large hematoma in his mid forearm.
DESCRIPTION OF OPERATION: The patient was taken back to the operating suite and placed under general inhalation anesthesia. The patient was prepped and draped in the usual fashion. The left upper extremity was esmarched and then the tourniquet was applied. The surgery was done in less than 30 minutes of tourniquet time. The incision was extended so that we could have better visualization. The antebrachial fascia was taken down, and we were able to visualize all the underlying structures. We drained a large hematoma from the muscle bellies with suction and then we irrigated the rest of the area out until we were able to find the radial artery transection. We went ahead and found the proximal and distal ends and freshened up both of the ends. They were mobilized so that they can be anastomosed without tension.
Marcaine 0.5% plain was instilled into the cavity of each of these so that we can get some dilation on those. They were repaired with a 6-0 Prolene in a simple interrupted fashion, three different sutures. There was some oozing once it started, but it was stopped fairly easily with thrombin-coated Gelfoam. Superficial venous bleeding was all stopped with electrocautery. The Doppler was done, which showed good flow proximally and distally. We were actually able to get a radial artery Doppler fairly good. Even after occlusion of the ulnar artery, we were able to still get good radial artery Doppler.
The area was then irrigated with saline and suctioned back until clear. There was good hemostasis. The area was closed using inverted interrupted sutures of 3-0 Vicryl. Antibiotic ointment was applied and sterile dressing applied over this. The patient tolerated the procedure well and was taken to postanesthesia care unit in stable condition. All packs, instruments, and needles were accounted for.
